| Organization Name: | INTERVENTIONAL SPINE ASSOCIATES PA |
| NPI Number: | 1174912398 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT M SUTHERLAND (OFFICEER) |
| Mailing Address: | 2001 N Jefferson Ave Suite 200 Mount Pleasant |
| State: | TX US |
| Postal Code: | 754552338 |
| Phone Number: | 9035931738 |
| Fax Number: | 9035967852 |
| NPI Enumeration Date: | 01/12/2015 |
| NPI Last Update Date: | 02/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |